1350 - Metastatic NSCLC outcomes at a single Canadian institution over a decade

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Non-Small-Cell Lung Cancer, Metastatic
Presenter Shannon Otsuka
Authors S. Otsuka1, W. Boland1, D. Hao1, D. Morris1, D.G. Bebb2
  • 1Oncology, Tom Baker Cancer Centre/University of Calgary, T2N 4N2 - Calgary/CA
  • 2Medical Oncology, Tom Baker Cancer Centre/University of Calgary, T2N 4N2 - Calgary/CA

Abstract

Background

In the past 10 years, the standard of care in non small cell lung cancer has seen the adoption of several less toxic and better tolerated therapies, allowing a greater proportion of metastatic patients the opportunity to receive 2nd and even 3rd line treatment. We investigated whether this improvement in the number of available therapies for metastatic NSCLC had any bearing on overall patient survival, by retrospectively analyzing patients diagnosed in 1999, 2004 and 2009 at our centre.

Methods

Demographic details, clinical variables and outcome data were gathered retrospectively via chart review, on NSCLC patients diagnosed at the Tom Baker Cancer Centre (TBCC) in 1999, 2004 and 2009 (Glans-Look Lung Cancer Database). All patients were restaged according to the new 7th Edition of the American Joint Committee on Cancer TNM system for NSCLC staging. Survival was analyzed using the Kaplan-Meier method and differences measured by a log rank test.

Results

807 patients were included in the analysis (649 who were stage IV at diagnosis, 158 who recurred with metastatic disease). Of these patients, 22.1% received palliative systemic therapy (18.9% in 1999, 23.0% in 2004 and 23.1% in 2009). During this time, the proportion of patients who received 2 or more lines of treatment almost doubled (6.9% in 1999, 9.0% in 2004 and 12.7% in 2009). In addition, there was a trend towards increasing median overall survival (MOS) of systemically treated patients over 1999-2009, from 10.8 months (95% CI: 8.4-13.3) in 1999 to 14.7 months (95%CI: 9.6-14.4) in 2009 (p = 0.2).

Conclusions

Our analysis suggests that there is an increasing proportion of metastatic NSCLC patients being treated systemically at our centre, specifically, the proportion of patients being treated with two or more lines of systemic therapy has increased over the decade from 1999-2009. This study also suggests a trend toward an increased MOS for systemically treated patients diagnosed in 2009 compared to those diagnosed in 1999. However, the vast majority of patients (>3/4) are still not being treated with systemic therapy, despite the increase in available therapies now compared to a decade ago. The reasons for this are not clear but may include poor ECOG performance status, rapid decline, sub-optimal referral pathways and rural residence.

Disclosure

All authors have declared no conflicts of interest.